The community nurse and stoma care
Community nurses will have people with a stoma on their caseload, and a reminder about stoma and stoma care will hopefully increase confidence and, subsequently, care. There are approximately 205 000 people in the UK with a stoma; it is a common condition, with approximately one in every 340 people having a stoma. While quality of life with a stoma can be good, problems can occur, such as a leaking appliance that results in skin damage. Skin damage can occur for all people with a stoma, but is more common for people with an ileostomy. Appliance leakage can increase stoma care costs, time, financially as well as a decrease in quality of life, so it is important to be able to address issues when they arise or refer on as necessary.
There are now estimated to be approximately 205 000 people in the UK with a stoma (Hodges, 2022). The cost of stoma products used in the UK in 2020 was audited by the British Healthcare Trades Association (BHTA) and was determined to be £405 million (Hodges, 2022). Therefore, it is important to ensure that NHS resources are appropriately used. To achieve this, it is necessary to understand stoma care.
A stoma is formed during surgery by bringing part of the bowel through the abdominal wall and stitching it in place on the abdomen. There are three main types of output stoma: faecal output stomas are the colostomy and the ileostomy, while the urinary output stoma is termed an ileal conduit or urostomy. Stomas can be temporary or permanent. A temporary stoma will need a second operation to reverse or close the stoma, usually several months after the initial operation. Each stoma will be discussed separately to explore reasons for formation, appearance, output, appliances, any dietary changes and potential complications.
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